Alternative options for anti-reflux intervention in a personalized approach

Introduction. Hiatal hernia and gastroesophageal reflux disease are among the most common surgical pathologies, which entails the inclusion of fundoplication in the list of the most frequently performed elective surgeries in the "Surgery" profile. Due to the prevalence of the disease, a wealth of experience in scientific comprehension of the effectiveness of laparoscopic interventions by Nissen and Chernousov has been accumulated, while there is no orderly algorithm for choosing the type of antireflux surgical intervention.

The purpose of this study is to justify of alternative fundoplication options according to Nissen and Chernousov, depending on the prevalence of hiatal hernia or gastroesophageal reflux disease.

Materials and methods. The study is based on data obtained during treatment of 128 patients with hiatal hernias and gastroesophageal reflux disease at the I.V. Davydovsky City Clinical Hospital of the Moscow Health Department in the period from February 2020 to May 2025. The patients were divided into 2 clinical groups based on the prevalence of hiatal hernia (n=66) or gastroesophageal reflux disease (n=62). Both clinical groups were subsequently divided into two subgroups, depending on the type of fundoplication: Nissen or Chernousov.

Research results and discussion. The following indicators were used to assess intraoperative, early, and delayed outcomes: the average duration of surgery, blood loss volume, the number of intraoperative and postoperative complications according to Clavien-Dindo, as well as data from postoperative instrumental examinations and questionnaires 1 year after surgery.

Conclusion. In the prevalence of hiatal hernia symptoms, patients who underwent Nissen fundoplication showed the best postoperative results. At the same time, patients with Chernousov fundoplication showed more favorable results in the prevalence of GERD symptoms.

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